Presbycusis

Abstract

The inevitable deterioration in hearing ability that occurs with age--presbycusis--is a multifactorial process that can vary in severity from mild to substantial. Left untreated, presbycusis of a moderate or greater degree affects communication and can contribute to isolation, depression, and, possibly, dementia. These psychological effects are largely reversible with rehabilitative treatment. Comprehensive rehabilitation is widely available but underused because, in part, of social attitudes that undervalue hearing, in addition to the cost and stigma of hearing aids. Remediation of presbycusis is an important contributor to quality of life in geriatric medicine and can include education about communication effectiveness, hearing aids, assistive listening devices, and cochlear implants for severe hearing loss. Primary care physicians should screen and refer their elderly patients for assessment and remediation. Where hearing aids no longer provide benefit, cochlear implantation is the treatment of choice with excellent results even in octogenarians.

Prevalence of age-related hearing loss in Europe: a review

“…Given the biological variability of ARHL, it may be difficult to devise a universal approach for improving ARHL. Rehabilitation strategies may also have to consider the contribution of peripheral and central auditory aspects [42, 45]. Testing these components selectively is not well established and no experience with screening for them exists.…”

Ageing and hearing loss

“…Addressing the ARHL-NIHL interaction in humans is difficult and the results of studies on hearing losses in noise-exposed and/or ageing ears are contradictory and highly variable [22][23][24][25]. This variability may arise from underlying differences in actual noise exposure and because, in part, noise and ageing are both under the influence of other intrinsic and environmental variables that can, by themselves, lead to HL or alter NIHL and/or ARHL vulnerability.…”

“…However, it remains difficult to distinguish dysfunctions of the auditory nerve caused by a decreased EP from those resulting from degeneration of spiral ganglion neurons [27]. Agerelated asynchronous activity of the auditory nerve could account for age-related declines in temporal resolving abilities, which are sometimes interpreted as solely caused by age-related changes in the properties of the auditory central nervous system [25]. Strial presbycusis is generally considered to be an ageing effect independent of exogenous damage, whereas ageing and insults accumulated (most commonly noise exposure) over the course of a lifetime are believed to be the key factors implicated in sensory presbycusis.…”

“…Strial presbycusis is generally considered to be an ageing effect independent of exogenous damage, whereas ageing and insults accumulated (most commonly noise exposure) over the course of a lifetime are believed to be the key factors implicated in sensory presbycusis. There is evidence to suggest that NIHL and ARHL, once thought to be distinct pathological entities, may in fact be overlapping phenotypes [25]. Most ageing human and animal cochleae show a mix of pathologies affecting different cell types.…”

Genome-wide association analysis demonstrates the highly polygenic character of age-related hearing impairment

“…Age of onset, progression, and severity of age-related hearing impairment (ARHI) show great variation in the population, but with a demonstrable increased prevalence in males. 1 Heritability studies have shown that the sources of this variance are both genetic and environmental, with approximately half of the variance attributable to hereditary factors. 2 Only a limited number of genome-wide association studies (GWASs) have been performed up to now.…”